Navigating Cultural Nuances: Understanding and Addressing Formal Care Utilization among Latino Family Caregivers of Older Adults with Dementia
Bibliographic record
Abstract
Abstract Background In the United States, Latino older adults are 1.5x more likely to develop Alzheimer’s disease than non‐Latino White older adults. Latino Family Caregivers (LFC) maintain home care for longer periods of time but use formal care less. Latino cultural values such as familismo influence how LFC provide care, but many LFC report a lack of family assistance that might otherwise compensate for lower formal care usage. Methods Phenomenological methodology was employed to understand LFC of people with dementia (n = 14). Participants were both female (n = 6) and male (n = 8) and interviews were conducted in both English (n = 8) and Spanish (n = 6). These semi‐structured interviews were analyzed via content analysis using NVivo 14 software. A primarily inductive approach was used to code the interviews; however, concepts were influenced by the Ottawa Decision Support Framework. Results Two main categories were identified, (1) Reasons LFC might refrain from using formal care and (2) How/when LFC choose formal care. (1) Many LFC conceptualized formal care as untrustworthy (n = 10), unsafe (n = 8), expensive (n = 13), and found financial support elusive (n = 12). (2) However, LFC are likely to use at home formal care as disease severity progresses (n = 8). Discussing formal care decisions with family was common (n = 6), but consulting a doctor for advice was a majority preference (n = 11). LFC prized prior experience (n = 9) and “genuineness” in formal caregivers (n = 5). Lastly, although formal caregivers speaking Spanish was important (n = 8), embracing Latino culture was equally valuable (n = 8). Conclusion Health care professionals (especially doctors) should consider cultural nuances when suggesting formal care to LFC’s. There are preconceived notions that LFC’s do not consider formal care, however if the formal caregiver is trustworthy, professional, and embraces Latino culture, LFC’s are likely to use formal care when the time is right. Future interventions should assist LFC’s in identifying professional and culturally competent formal caregivers and locating financial resources.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.008 | 0.011 |
| Meta-epidemiology (narrow) | 0.001 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.007 | 0.006 |
| Scholarly communication | 0.005 | 0.005 |
| Open science | 0.002 | 0.006 |
| Research integrity | 0.001 | 0.002 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".